Delhi Journal of Ophthalmology

Idiopathic, Isolated, Recurrent, Ipsilateral Sixth Nerve Paresis in An Older Adult - A Rare Case Report

Srinivasa Rao Nambula, Sai Rani Karanam, Mahathi Vankireddy, Shalini Gujjula
Paediatric Ophthalmology, Sankara Eye Hospital, Guntur, Andhra Pradesh, India

Editor-in-Chief, Delhi Journal of Ophthalmology, Dr R.P.Centre, AIIMS.


Corresponding Author:

Srinivasa Rao Nambula 
MBBS, DNB (Ophta)
Sankara Eye Hospital, Vijayawada-Guntur Express Highway, Peadakakani, Guntur, Andhra Pradesh, India
Email id: drsrinivasnambula@gmail.com


Received: 01-AUG-2019 Accepted: 10-DEC-2019 Published Online: 21-JUN-2020
DOI: https://dx.doi.org/10.7869/djo.547

Abstract
Recurrent, unilateral, isolated, idiopathic lateral rectus muscle paresis is an uncommon but well-recognized disorder in children but has not been recognized as well in other age groups. Here we are reporting a case of idiopathic, isolated, recurrent, ipsilateral sixth nerve paresis in an otherwise healthy older adult. A 46 years gentle man presented with double vision since 3 years. He had similar episodes of double vision 5 times all of which recovered completely, except the last time. On examination there was right esotropia, limitation of right abduction and a normal fundus. Diplopia and Hess charting verified partial 6th nerve paresis. The patient was investigated with a wide range of investigations to rule out tumors, demyelinating, infectious, restrictive and neuromuscular junctional causes all of which were normal. Patient underwent surgical correction of esotropia and he is asymptomatic till date and is under a close follow up.

Keywords :Idiopathic, isolated, recurrent, ipsilateral sixth nerve paresis, older adult